Think of Kloxxado as a Higher-Dose Naloxone Nasal Spray

Kloxxado, a new naloxone nasal spray, will raise questions about which product to use in patients taking opioids.

Think of Kloxxado as having twice as much naloxone per dose as Narcan nasal spray. Kloxxado contains 8 mg naloxone per spray...Narcan has 4 mg per spray.

There's some buzz that higher naloxone doses may be needed, since overdoses from "ultra-potent" fentanyl-like compounds are on the rise.

But any rescue naloxone product can help save a life. Kloxxado doesn't seem to be more quicker...or last longer.

There are also concerns that higher naloxone doses may lead to more severe withdrawal symptoms...such as agitation or combativeness.

Expect Kloxxado to be used the same way as Narcan. It's one spray administered into one nostril during an overdose...with a repeat dose every 2 to 3 minutes if needed, alternating nostrils.

Anticipate that clinicians will continue to focus on ensuring patients who take opioids have SOME form of naloxone after discharge.

Don't be surprised if they focus less on WHICH form. Kloxxado or Narcan costs about $130/2 doses...and both are ready to use. Pharmacy-assembled IM or intranasal kits cost less...but aren't as convenient.

Find more on naloxone dispensing and storage, plus a new injectable product, in our Naloxone for Opioid Overdose FAQ.

Key References

  • (10-29-21)
  • (10-29-21)
  • J Addict Med. 2020 Mar/Apr;14(2S Suppl 1):1-91
  • J Med Toxicol. 2020 Jan;16(1):41-48
  • (10-29-21)
  • Medication pricing by Elsevier, accessed Oct 2021
Hospital Pharmacy Technician's Letter. November 2021, No. 371124

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